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CN1148795A - 支撑架 - Google Patents

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CN1148795A
CN1148795A CN95193206A CN95193206A CN1148795A CN 1148795 A CN1148795 A CN 1148795A CN 95193206 A CN95193206 A CN 95193206A CN 95193206 A CN95193206 A CN 95193206A CN 1148795 A CN1148795 A CN 1148795A
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阿克塞尔·基施
瓦尔特·迪尔
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Eberle Medical Tech Component GmbH
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8085—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates with pliable or malleable elements or having a mesh-like structure, e.g. small strips
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/28—Bones
    • A61F2/2803—Bones for mandibular reconstruction
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/28—Bones
    • A61F2/2846—Support means for bone substitute or for bone graft implants, e.g. membranes or plates for covering bone defects
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/28—Bones
    • A61F2002/2835—Bone graft implants for filling a bony defect or an endoprosthesis cavity, e.g. by synthetic material or biological material
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30576—Special structural features of bone or joint prostheses not otherwise provided for with extending fixation tabs
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30594—Special structural features of bone or joint prostheses not otherwise provided for slotted, e.g. radial or meridian slot ending in a polar aperture, non-polar slots, horizontal or arcuate slots
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2/30907—Nets or sleeves applied to surface of prostheses or in cement
    • A61F2002/30909—Nets
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F13/00—Bandages or dressings; Absorbent pads
    • A61F2013/00089—Wound bandages
    • A61F2013/00357—Wound bandages implanted wound fillings or covers
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2310/00—Prostheses classified in A61F2/28 or A61F2/30 - A61F2/44 being constructed from or coated with a particular material
    • A61F2310/00005—The prosthesis being constructed from a particular material
    • A61F2310/00179—Ceramics or ceramic-like structures
    • A61F2310/00293—Ceramics or ceramic-like structures containing a phosphorus-containing compound, e.g. apatite
    • Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
    • Y10S—TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10S606/00—Surgery
    • Y10S606/902—Cortical plate specifically adapted for a particular bone
    • Y10S606/903—Cranial and facial plate
    • Y10S606/904—Jaw plate

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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
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  • Engineering & Computer Science (AREA)
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  • Heart & Thoracic Surgery (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • Transplantation (AREA)
  • Vascular Medicine (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
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  • Neurology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Plastic & Reconstructive Surgery (AREA)
  • Prostheses (AREA)
  • Surgical Instruments (AREA)
  • Materials For Medical Uses (AREA)

Abstract

用于机械地支承覆盖在本体骨组织内用骨质替代材料，如羟灰石颗粒充填的骨骼缺陷部位(尤其是孔洞)上的盖膜的支撑架，其特征为，支撑架可绕至少一根事先确定的通过支撑架构型的轴线弯曲。

Description

支撑架
本发明涉及一种支撑架，用于机械地支承覆盖在本体骨组织内用骨质替代材料，如羟磷灰石颗粒充填的骨骼缺陷部位(尤其是孔洞)上的盖膜。
在骨外科学中，例如在整形外科中骨的重建或在颌外科手术中，通常对在本体骨组织中形式上为缺损或孔洞的骨缺陷部位用骨质材料充填，这种骨质材料一般由一种骨质替代材料(如羟磷灰石颗粒)与本体骨颗粒的混合物构成。直至由特殊的骨替代材料形成替代骨之前，这类骨缺陷部位必须借助于通过支撑架在机械上稳定化的盖膜覆盖。
由DE9115341 U1已知一种用于特殊的骨替代材料覆盖物的支撑架，它由一种可生物分解和可热塑性成型的聚合物制成。此支撑架用作骨替代材料的机械支承，并例如在下颌骨完全断裂时用于使得这两个残端互相固定。然而，它只能有有限的弯曲，并因而只能在较高的费用支出的情况下适应所要处置的骨骼的形状。
本发明的目的是提供一种新型的支撑架，它能克服上述缺点，并准确和低成本地适应要处置的骨骼尤其是颌骨的形状。
因此本发明的目的是对支撑架作下列改进，保证支撑架无可指摘地适应骨缺陷部位的形状，以及适应此骨缺陷部位周围的本体骨骼的形状。
按本发明此目的通过此类支撑架的下列改进达到：支撑架可绕至少一根事先确定的通过支撑架构型的轴线弯曲。
按本发明建议，未弯曲的支撑架外形基本上相应于一个圆环段的外形。
按本发明还规定，支撑架可绕至少一根与圆环段外圆弧同心并位于未弯曲支撑架平面内的轴线弯曲。
除此之外，建立支撑架可绕一根轴线垂直地弯曲到未弯曲支撑架平面上方和此平面之外。
在本发明进一步设计中规定，支撑架沿圆环段的内圆弧和外圆弧制有缺口。
沿内圆弧的缺口最好相对于沿外圆弧的缺口错开排列。
本发明还建议，沿内圆弧的缺口和沿外圆弧的缺口各自具有统一的造型。
本发明除此之外建议，沿内圆弧的缺口的造型与沿外圆弧的缺口的造型是不同的。
在内圆弧处的缺口和在外圆弧处的缺口最好各有一根径向对称轴线。
在此新型支撑架的一种有利的设计中规定，在内圆弧处的缺口在紧邻内圆弧处横向于径向对称轴线的宽度，比在外圆弧处的缺口在紧邻外圆弧处的更宽。
此外还建议，在外圆弧处的缺口设计为，从外轮廓沿径向向里凹，然后收缩成锥形。
本发明还规定，在内圆弧处的缺口设计为，从内轮廓沿径向向外，首先基本上为直管状，然后比较小量地扩张成圆形，直至重新缩小到一个最小宽度，再呈直管状地经过一个较短的区域，以及，最后大量扩张并接着收缩成锥形。
在内圆弧处的缺口锥形段的底部，最好处在几乎与在外圆弧处的缺口锥形段的顶所在的同一个半径上。
此外本发明还规定，支撑架沿内圆弧和外圆弧有朝外轮廓开口的辅助缺口。
本发明以令人吃惊的认识为基础，即它顺利地克服了此类支撑架使用在某些使用场合时尚存在的困难，这是通过使支撑架具有一种格栅结构，这种格栅结构允许制成为适应骨骼外形所必要的球形结构。
这种新型的支撑架改善和简化了与要处置的骨骼外形的匹配，并在某些情况下甚至允许取消制造预成型模。
特别有利的是，例如涉及支承在颌骨中的骨缺陷部位的支承装置，在这种情况下如本发明的一种实施形式所规定的那样，使支撑架可绕一根轴线垂直地弯曲到未弯曲的支撑架平面的上面和此平面之外。
本发明的其他特征和优点由权利要求和由下面的说明中给出，在下面的说明中借助于示意图详细阐明了一种实施例。其中：
图1未弯曲的支撑架俯视图；
图2沿图1支撑架的线II-II的剖面图，支撑架处于弯曲状态；以及
图3图1支撑架已弯曲后的透视图。
图1表示一个支撑架10，它的外形象一个圆环段。无论在圆环段的内圆弧还是在它的外圆弧上都有缺口16和18。沿着内圆弧的缺口16相对于沿外圆弧的缺口18错开排列，并各具有统一的造型。沿内圆弧的缺口16的造型与沿外圆弧的缺口18的造型是不同的。缺口16和18各有一根径向对称轴线20或22。在内圆弧处的缺口在紧邻此内圆弧处横向于径向对称轴线20的宽度，比在外圆弧处的缺口18在紧邻外圆弧处的宽度更宽。在外圆弧处的缺口18设计为从外轮廓起沿径向内凹，然后收缩成锥形，而在内圆弧处的缺口16设计为从内轮廓起沿径向向外，首先基本上为直管状，然后比较小量地扩张成圆形，直至重新缩小到一个最小宽度，再呈直管状地经过一个较短的区域，以及，最后大量扩张并接着收缩成锥形。在内圆弧处的缺口16锥形段的底部，位于几乎与在外圆弧处的缺口18锥形段的顶所在的同一个半径上。除此之外，支撑架10沿内圆弧和外圆弧有朝外轮廓开口的辅助缺口24和26。由于缺口16和18的这种造型和安排，支撑架可绕两根轴线12和14弯曲，它们与外圆弧同心，并位于支撑架10的平面内。
图2表示弯曲后的支撑架10沿线II-II的剖面图。为了完整起见，图2还表示了由支撑架10支承着的盖膜28，在图1和3中为了使视图看得更清楚所以没有表示此盖膜28。通过缺口的造型和排列，预先规定了弯曲轴线在支撑架10的平面内，并造成了如图2中所表示的弯曲示意图形式。支撑架10的结构还可以是，使支撑架10附加地绕一根轴线垂直地弯曲到支撑架10的平面上方和平面之外。因此，这种实施例尤其适用于支承在颌骨中的骨缺陷部位。
图3的透视图清楚地说明了此实施例对颌骨的良好适应性。
在上面的说明中，在附图以及在权利要求中所公开的本发明的特征在既可以单独地也可以任意组合地用于在本发明的各种不同的实施形式中实现本发明时都应是重要的。

Claims (14)

1.用于机械地支承覆盖在本体骨组织内用骨质替代材料，如羟磷灰石颗粒充填的骨骼缺陷部位(尤其是孔洞)上的盖膜的支撑架，其特征为：支撑架(10)可绕至少一根事先确定的通过支撑架(10)构型的轴线(12、14)弯曲。
2.按照权利要求1所述之支撑架，其特征为：未弯曲的支撑架(10)的外形基本上相应于一个圆环段的外形。
3.按照权利要求2所述之支撑架，其特征为：支撑架(10)可绕至少一根与圆环段的外圆弧同心并位于未弯曲支撑架(10)平面内的轴线(12、14)弯曲。
4.按照前列诸权利要求之一所述之支撑架，其特征为：支撑架(10)可绕一根轴线垂直地弯曲到未弯曲支撑架(10)的平面上面和此平面之外。
5.按照权利要求2至4之一所述之支撑架，其特征为：支撑架(10)沿圆环段的内圆弧和外圆弧制有缺口(16、18)。
6.按照权利要求5所述之支撑架，其特征为：沿内圆弧的缺口(16)与沿外圆弧的缺口(18)错开排列。
7.按照权利要求5或6所述之支撑架，其特征为：沿内圆弧的缺口(16)和沿外圆弧的缺口(18)，各具有统一的造型。
8.按照权利要求5至7之一所述之支撑架，其特征为：沿内圆弧的缺口(16)的造型与沿外圆弧的缺口(18)的造型是不同的。
9.按照权利要求5至8之一所述之支撑架，其特征为：缺口(16)和(18)各有一根径向对称轴线(20)或(22)。
10.按照权利要求5至9之一所述之支撑架，其特征为：在内圆弧处的缺口(16)在紧邻内圆弧处横向于径向对称轴线(20)的宽度，比在外圆弧处的缺口(18)紧邻外圆弧处的宽度更宽。
11.按照权利要求5至10之一所述之支撑架，其特征为：在外圆弧处的缺口(18)设计为，从外轮廓起沿径向向内凹，然后收缩成锥形。
12.按照权利要求5至11之一所述之支撑架，其特征为：在内圆弧处的缺口(16)设计为，从内轮廓沿径向向外，首先基本上为直管状，然后比较小量地扩张成圆形，直至重新收缩到一个最小宽度，再呈直管状地经过一个较短的区域，以及，最后较大量地扩张并接着收缩成锥形。
13.按照权利要求12所述之支撑架，其特征为：在内圆弧处的缺口(16)锥形段的底，几乎位于在外圆弧处的缺口(18)锥形段的顶所在的同一个半径上。
14.按照前列诸权利要求之一所述之支撑架，其特征为：支撑架(10)沿内圆弧和外圆弧设有朝外轮廓开口的辅助缺口(24、26)。
CN95193206A 1994-05-25 1995-05-03 支撑架 Pending CN1148795A (zh)

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AU2342695A (en) 1995-12-18
BR9507880A (pt) 1997-08-19
WO1995031940A3 (de) 1995-12-21
JPH09511669A (ja) 1997-11-25
WO1995031940A2 (de) 1995-11-30
EP0760630A1 (de) 1997-03-12
DE4418159C1 (de) 1995-09-14

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